Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Pennsylvania for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Pennsylvania only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Pennsylvania (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys (NPI 1063489342)

Field	Value
Entity Type	Organization
Organization	The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys
Address	800 Spruce St
City	Phila
State	PA
ZIP	19107
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 4, 2006

Payer Source	Total Paid
Medicaid	$25.7M
Medicare	$0

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

297 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0378	Hospital observation service, per hour	6,370	$1,090	$6.9M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	24,620	$200	$4.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	18,400	$200	$3.7M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	17,360	$200	$3.5M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	7,530	$80	$595.1K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	3,120	$130	$402.9K
64483	This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).	280	$1,230	$341.4K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	250	$1,010	$250.7K
57420	In this procedure, the provider performs a diagnostic examination of the vagina and cervix, if present, using a colposcope.	180	$1,120	$198.5K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3,330	$60	$183.4K

Showing 1–10 of 297

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Pennsylvania providers billing the same CPT/HCPCS codes.

Claims Volume vs. Pennsylvania Distribution

The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

297 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0378	Hospital observation service, per hour	8	150	510	$870	$1.4M
T1015	Clinic visit/encounter, all-inclusive	770	1,690	760	$170	$1.2M
J9271	Injection, pembrolizumab, 1 mg	22	20	420	$1,230	$827.7K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	36	210	730	$40	$689.7K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	32	200	990	$70	$517.5K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	14	20	3,040	$60	$483.4K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	49	1,600	270	$120	$409.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	53	1,060	150	$130	$405.4K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	4	10	50	$810	$332.9K
J7307	Etonogestrel (contraceptive) implant system, including implant and supplies	19	30	180	$570	$331.3K

Showing 1–10 of 297

Related Providers

Other providers that share a Tax Identification Number (TIN) with The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys	PA	Endoscopy Clinic/Center	$419.9K	$69.5K

Nearby Providers

Other providers in the same ZIP code as The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Quality Progressions	PA	Case Management Agency	$0	$50.8M
Bright Beginnings Therapeutic Services, LLC	PA	Community/Behavioral Health Agency	$0	$46.8M
Thomas Jefferson University Hospitals Inc	PA	General Acute Care Hospital	$0	$40.3M
Jefferson University Physicians	PA	General Practice Physician	$0	$30.8M
Philadelphia Mental Health Clinic	PA	Clinic/Center	$0	$18.3M
Philadelphia Fight	PA	Federally Qualified Health Center (FQHC)	$0	$18.1M
Public Health Mangement Corporation	PA	Federally Qualified Health Center (FQHC)	$0	$9.3M
Addiction Medicine And Health Advocates, Incorporated	PA	Methadone Clinic	$56.9K	$9.2M
Assessment & Treatment Alternatives	PA	Community/Behavioral Health Agency	$0	$9.1M
Nadia Darbouze	PA	Social Worker	$0	$9.1M

The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys — Billing Profile & Reimbursement Data

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The Pennsylvania Hospital Of The University Of Pennsylvania Health Sys — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References